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What is vagus nerve stimulation (VNS)?
VNS is often advised when patients with pharmacoresistant seizures are not candidates for epilepsy surgery with resection/ablation or decline such surgery.
An incision along the anterior left sternomastoid is used to implant wire electrodes to the left vagus nerve, which are stimulated with a pulse generator implanted in the left upper chest wall.
How effective is it in reducing seizures?
The antiepileptic effect increases over months to years, and a greater than 50% seizure reduction is seen in 27% of patients.
Seizure freedom may be attained in 5%. Adverse effects include hoarseness (from recurrent laryngeal stimulation), cough, dyspnea, and neck pain.
